冠心病患者颈动脉粥样硬化和肱动脉舒张功能的超声检测

目的探讨冠心病患者颈动脉粥样硬化情况和肱动脉内皮依赖性舒张功能的变化以及外周血管超声预测冠心病的临床价值。方法采用高分辨率超声测定132例受试者颈动脉内中膜厚度和斑块积分及肱动脉内皮依赖性舒张功能。结果冠心病组颈动脉内中膜厚度明显大于对照组[(0.87±0.16)mmvs(0.72±0.13)mm,P<0.01]。冠心病组斑块发生率明显高于对照组。冠心病多支病变组mIMTc较单支病变组明显增厚[(0.99±0.17)mmvs(0.85±0.15)mm,P<0.01],其斑块积分也较单支病变组高。在93例接受冠脉造影检查的患者中,有47例阳性的冠心病患者以mIMTc≥0.85mm预测冠心病的有无,其敏感性为72.3%,特异性为76.1%,总符合率74.2%(69/93)。冠心病患者肱动脉内皮依赖性舒张功能明显低于对照组[(6.21±1.92)%vs(9.04±3.03)%,P<0.01],132例受试者颈动脉内中膜厚度与肱动脉内皮依赖性舒张功能呈负相关,而在冠心病患者中两者无相关性。结论颈动脉粥样硬化程度可间接反映冠状动脉病变的程度。冠心病患者存在肱动脉内皮依赖性舒张功能的受损和颈动脉內中膜厚度的增厚。     

冠心病患者下肢动脉硬化的超声检测及意义

目的:应用二维及彩色多普勒超声方法对已确诊冠心病患者下肢动脉疾病情况进行分析探讨,了解下肢动脉硬化与冠心病之间关系。方法:采用高频探头对临床已确诊的冠心病患者136例(冠心病组)及非冠心病对照者100例(对照组)进行分析对比,观察下肢动脉粥样硬化程度(包括内中膜厚度、有无斑块形成)。结果:冠心病组与对照组相比,冠心病组下肢动脉硬化斑块检出率明显高于对照组,为70.6%vs12.0%(P<0.01),并随冠状动脉病变程度增加下肢动脉硬化斑块检出率明显增加,多支病变组下肢动脉粥样硬化斑块发生率高于单只病变组,为87.5%vs46.4%(P<0.01)。结论:下肢动脉硬化与冠心病之间存在一定相关性,下肢动脉硬化对冠心病发生及病变程度的预测有重要意义,在一定程度上反映冠状动脉粥样硬化的有无和病变程度。     

老年冠心病患者血管内皮功能、颈动脉内中膜厚度、冠状动脉钙化积分变化的研究

目的探讨老年冠心病患者的血管内皮功能、颈动脉内中膜厚度及斑块、冠状动脉钙化积分的变化及相互关系.方法对30例老年冠心病组,24例无冠心病老年对照组采用高分辨超声检测肱动脉基础动脉内径(D0)、内皮依赖性血流介导的舒张功能(FMD)、非内皮依赖性硝酸甘油介导的舒张功能(NID),颈动脉超声检测颈动脉内中膜厚度(IMTc)及斑块,螺旋CT检测各冠状动脉钙化积分(CS)及冠脉总钙化积分(TCS).结果冠心病组的FMD、NID低于对照组(P<0.001), D0两组差别无统计学意义(P>0.05);IMTc、CS及TCS明显高于对照组(P<0.01),颈动脉多发性硬斑发生率高于对照组(P<0.01).IMTc与CS、TCS呈正相关(P<0.01),IMTc、CS、TCS与FMD、NID呈负相关(P<0.01).结论老年冠心病患者存在较严重的血管内皮功能失调、颈动脉粥样硬化及冠状动脉钙化.肱动脉舒张功能、颈动脉内中膜厚度及斑块、冠状动脉钙化积分的测定对冠心病的预测和防治具有重要意义.     

乙醛脱氢酶2基因多态性与血管内皮功能及动脉粥样硬化关系的研究

目的应用高分辨力超声技术对肱动脉舒张功能及血流动力学进行评价,并结合定量冠状动脉(冠脉)造影结果,探讨乙醛脱氢酶2(ALDH2)基因多态性与血管内皮功能及动脉粥样硬化之间关系。方法150例经冠脉造影证实的冠心病患者,根据基因测序结果分为A组(野生型)93例(62%)和B组(突变型)57例(38%),观察两组患者冠心病易患因素及冠状动脉病变程度,同时应用高分辨力超声技术评价肱动脉舒张功能及相应状态下血流最大剪切率。结果两组患者基本临床特征比较差异无统计学意义(P>0.05)。B组患者多支病变率显著低于A组(57.9%对76.4%,P=0.017),Gensini评分亦低于A组(46.3±35.7对61.8±49.3,P=0.04)。高分辨力超声检查:肱动脉基础内径两组间差异无统计学意义(P>0.05)。内皮依赖性血管舒张功能检查:反应性充血后肱动脉内径变化两组间差异无统计学意义(P>0.05);非内皮依赖性血管舒张功能检查:含化硝酸甘油后B组血管内径的增幅较A组显著减少(P<0.05),表明B组患者对硝酸酯类药物反应能力较低。脉冲多普勒检查血流动力学,基础状态及反应性充血后肱动脉最大剪切率A组显著低于B组(P<0.01),提示野生型患者易发生动脉粥样硬化。结论ALDH2基因多态性与血管内皮功能及动脉粥样硬化之间关系密切。ALDH2基因突变虽可导致非内皮依赖性血管舒张功能障碍,但内皮依赖性血管舒张功能不受影响。ALDH2基因突变可能具有抗动脉粥样硬化的作用。     

非洛地平对高血压患者动脉粥样硬化和血管内皮功能的影响

目的探讨非洛地平对高血压病患者颈动脉粥样硬化和内皮功能的影响。方法将高血压病患者随机分为A组n=35(非洛地平治疗组)和B组n=35(福辛普利治疗组),另设年龄、性别与之匹配的正常人为C组n=30(对照组)。用高分辨超声技术检测各组对象的肱动脉内皮依赖性舒张功能、颈动脉平均内中膜厚度、颈动脉斑块发生率及Croouse积分。对A、B组分别在治疗3个月、1年及2年后复查血压和血管超声的上述指标。结果与C组比较,A组与B组肱动脉内皮依赖性舒张功能减退,颈动脉内中膜增厚(P<0.01)。非洛地平组与福辛普利组在降低血压及改善血管内皮依赖性舒张功能方面作用相同(P>0.05),但非洛地平组在逆转颈动脉内中膜厚度、降低新的粥样斑块发生率方面优于福辛普利组(P<0.01)。结论非洛地平除能有效降低高血压患者的血压外,还有逆转大动脉功能和结构异常,延缓动脉粥样硬化发生发展的作用。     

动态动脉硬化指数及颈动脉超声与冠心病的关系研究

【】 目的 探讨动态动脉硬化指数(AASI)、颈动脉超声相关指标与冠心病的关系。方法 检测110例冠心病患者AASI、颈动脉超声、冠状动脉造影,根据冠状动脉造影结果分为单支病变组(n=40)、2支病变组(n=37)、3支及以上病变组(n=33),同时根据超声颈动脉检查分为颈动脉轻度狭窄组(n=42)、中度狭窄组(n=46)、重度狭窄组(n=22),选取同期健康查体人员50例作为正常对照组,对比四组患者血压、AASI、颈动脉内中膜厚度(IMT)、颈动脉粥样硬化斑块积分、冠状动脉评分,并进行相关性分析。结果 ①血压：不同冠脉病变支数、不同颈动脉狭窄程度患者SBP、DBP比较差异无统计学差异(P>0.05)；②AASI：3支病变组AASI>2支病变组>单支病变组>对照组(P<0.05),重度颈动脉狭窄AASI＞中度＞轻度＞对照组(P＜0.05)；③IMT：冠心病患者IMT均显著高于与对照组(P<0.05),但冠心病各组间IMT比较无统计学差异(P>0.05)；④斑块积分及冠脉评分：3支病变组斑块积分与冠脉评分>2支病变组>1支病变组>对照组(P<0.05),重度狭窄斑块积分及冠脉评分均＞中度＞轻度＞对照组(P＜0.05)；⑤相关性：AASI与冠脉病变支数、颈动脉狭窄程度均呈正相关(r=0.72,0.65,P<0.05),斑块积分、冠脉评分均与冠脉病变支数、颈动脉狭窄程度均呈正相关(r=0.88,0.19,0.42,0.31,P<0.05)。结论 动态动脉硬化指数及颈动脉超声相关指标能够客观反映患者动脉硬化程度、动脉粥样硬化斑块病变程度,早期对冠心病的风险进行预测和评估,为临床早期干预提供客观可靠的依据。     

老年周围动脉疾病患者上下肢动脉舒张功能对比

背景:血管内皮功能失调是动脉粥样硬化的最初事件,目前评价血管内皮功能的方法较多,但适用于临床推广的方法较少.目的:观察老年周围动脉疾病患者肱动脉及股浅动脉内皮依赖件舒张功能和硝酸甘油介导的非内皮依赖性舒张功能,探讨上下肢动脉舒张功能相关性及特点.设计、时间和地点:非随机化同期对照实验,于2000-10/2002-05在解放军总医院老年心内科完成.对象:选择2000-10/2002-05解放军总医院住院的周围动脉疾病患者33例作为周围动脉疾病组,男27例,女6例.年龄(79±6)岁.均经超声多普勒检查下肢动脉一处以上动脉硬化斑块凸起及管腔狭窄≥50%,且年龄≥60岁.选择同期本院门诊进行健康体检的离退休干部40例作为健康对照组,均为符合中华医学会老年医学学会1995年对健康老人标准的建议.选择木院同期有冠状动脉硬化性心脏病及其危险因素并除外周围动脉疾病的患者30例为心血管危险凶素组.方法:采用无创的方法应用美国通用电器公司生产的Logiq 500型高分辨率彩色多普勒超声诊断系统检测纳入对象的肱动脉及股浅动脉的基础管径,然后阻断该动脉的血流并重新恢复血流后再次检测血管内径,评价其内皮依赖性舒张功能.检测肢体动脉基础内径后,舌下含服硝酸甘油片0.6mg导致血管扩张,以前后两次之差代表该动脉的非内皮依赖性舒张程度.主要观察指标:3组肢体动脉的内皮依赖性舒张功能及非内皮依赖性舒张功能.结果:周围动脉疾病组患者肱动脉的内皮依赖性舒张程度和非内皮依赖性舒张程度与股浅动脉的内皮依赖性舒张程度和非内皮依赖性舒张程度均明显低于健康对照组和心血管危险因素组,差异有显著性意义(t=-11.82～10.91,P<0.05).周围动脉疾病组患者股浅动脉的内皮依赖性舒张程度和非内皮依赖性舒张程度明显低丁肱动脉,差异有显著性意义(t=3.535,3.135,P<0.01);股浅动脉的内皮依赖件舒张程度和非内皮依赖性舒张程度与肱动脉的相关性好(r=0.931 4,0.919 1,P<0.01).结论:股浅动脉的内皮依赖性舒张功能及非内皮依赖性舒张功能能更敏感、更直接地反映老年周围动脉疾病患者的血管反应性.股浅动脉与肱动脉相关性好.     

原发性高血压患者颈动脉内膜-中层厚度与外周血管内皮功能的关系

目的:应用超声观察原发性高血压患者颈动脉内膜-中层厚度(intima-mediathickness,IMT)并探讨其血管内皮功能及两者的相关性为早期干预、防治心脑血管疾病提供有力证据。方法:高血压组:选择山东省泰山疗养院126例原发性高血压患者,平均年龄(64±8)岁。另选30例健康人为对照组。测定126例高血压患者颈动脉内膜-中层厚度及反应性充血时和舌下含服硝酸甘油后肱动脉内径的变化,并与对照组进行比较,分析各指标相关性。结果:高血压患者IMT犤(1.06±0.05)mm犦明显比正常对照组犤(0.73±0.02)mm犦增厚(t=57.29,P<0.001)。反应性充血时肱动脉内径的扩张程度明显低于对照组(t=25.8P<0.001)。颈动脉内膜厚度与反应性充血时和舌下含服硝酸甘油后肱动脉内径变化呈显著负相关(r=-0.538,-0.46,P<0.001)。结论:原发性高血压患者存在明显的血管内皮依赖性及非依赖性舒张功能的损伤;内皮功能紊乱引起血管重构、肥厚、斑块形成。原发性高血压的内皮功能损伤促进了动脉粥样硬化的发生并加速了动脉粥样硬化的进程。     

颈动脉内-中膜厚度与冠状动脉病变严重程度相关性研究

目的探讨颈动脉内-中膜厚度(IMT)及动脉粥样硬化斑块与冠状动脉粥样硬化狭窄程度的相关性。方法对198例拟诊冠心病并行冠脉造影的患者为研究对象,根据管腔狭窄程度分为非冠心病组(50例)和冠心病组(148例);并将冠心病组分为单支病变组(48例)、双支病变组(56例)及多支病变组(44例)并进行Gensini积分。所有患者均行双侧颈动脉彩色多普勒超声检查,检测颈动脉IMT及斑块Crouse积分情况,并对冠状动脉Gensini积分行相关性分析。结果 CAD组多支病变、双支病变、单支病变亚组及对照组冠状动脉Gensini积分分别为45.06±7.27、30.83±4.50、24.83±4.94和13.75±1.74,颈动脉IMT分别为(2.13±0.32)mm、(1.68±0.14)mm、(1.12±0.13)mm和(0.93±0.17)mm,颈动脉粥样硬化斑块Crouse积分分别为2.85±1.21、1.62±0.14、1.03±0.09、0.29±0.08,组间差异有统计学意义(P<0.05)。冠心病组颈动脉IMT及粥样斑块Crouse积分与冠状动脉Gensini积分呈正相关。结论颈动脉IMT及粥样斑块与冠状动脉粥样硬化狭窄程度、范围有密切相关性。颈动脉超声检查可作为筛查CAD和评价抗动脉硬化治疗疗效的一种手段。     

早期糖尿病患者外周血管和肱动脉舒张功能的检测分析

目的 评价早期糖尿病患者的血管舒张功能(包括血管内皮功能和平滑肌功能),并分析血管内皮功能受损和平滑肌功能受损之间的联系。 方法 用高分辨力超声对50例经临床确诊为早期糖尿病且符合超声检查无发生动脉粥样硬化标准的患者及正常对照组进行检测,测定内容有:1、颈总动脉、髂总动脉、股动脉内中膜厚度(IMT);2、肱动脉对硝酸甘油(NTG)介导的非内皮依赖性血管舒张功能(EIDD)及血流介导的内皮依赖性血管舒张功能(EDD)。 结果 早期糖尿病患者IMT较正常对照组无明显增厚,EDD的变化在两组间有显著差异(P<0.01),而EIDD虽较对照组降低,但无统计学意义。早期无动脉粥样硬化的糖尿病患者肱动脉内皮功能受损与平滑肌功能受损不具相关性。 结论 早期糖尿病患者内皮功能不全的发生早于IMT的改变和平滑肌功能不全的发生,超声检测内皮功能有助于判断患者是否有发生动脉粥样硬化的趋势。     

Endothelial function and hemodynamics in systemic sclerosis

Introduction: Systemic sclerosis (SSc) is characterized by the development of fibrosis of skin and internal organs that is associated with vascular damage. However, its related parameters have not been fully explored. The aim of this study was to investigate endothelial function in SSc and its relationship with systolic pulmonary artery pressure and systemic arterial compliance (SAC). Methods: We studied 14 SSc females (4 with diffuse and 10 with limited cutaneous form of the disease) and 14 healthy controls matched for age and for cardiovascular risk factors. Endothelium‐dependent dilation (i.e. flow‐mediated) and endothelium‐independent (i.e. nitroglycerin‐induced) dilation of the brachial artery were measured as the percentage of change from baseline (FMD and NMD, respectively). In patients with SSc, SAC, cardiac output (CO), systemic arterial resistance and pulmonary artery pressure were estimated using echocardiography Doppler. Results: Heart rate, brachial artery pressure and body mass index did not differ between patients with SSc and controls. Flow‐mediated vasodilation (FMD) and NMD were significantly decreased in patients with SSc (10·3 ± 8·6 versus 26·6 ± 7·4%, P<0·001; 24·2 ± 8·4 versus 33·3 ± 10·1%, P<0·001, respectively). Postischaemia reactive hyperaemia was lower in patients with SSc (275 ± 185 versus 618 ± 366%, P<0·001). FMD and nitrate‐mediated dilation (NMD) were associated with CO, but not with SAC; moreover, FMD correlated with pulmonary artery pressure and peripheral arterial resistance conversely to NMD. Conclusions: Endothelium function in SSc is impaired independently to SAC. Furthermore, the severity of both small artery and pulmonary artery involvement may impact on endothelium‐dependant function.     

组织多普勒成像技术对冠心病舒张功能的评价

目的 运用组织多普勒成像(DTI)技术观察冠心病的室壁运动情况。方法 用DTI检测经临床确诊的31例冠心病患者(26例冠状动脉狭窄和5例心肌梗死)室壁运动和二尖瓣血流频谱，并与对照组进行比较。结果 冠心病组室间隔、左室侧壁及后壁的E峰显著降低，A峰增高，E／A值降低，二尖瓣口的多普勒频谱E峰和E／A值与正常对照组比较无显著差异。E峰减速时间(DT)和E峰时间(ET)较正常对照组延长。结论 组织多普勒技术可较客观地反映冠心病左室壁舒张运动，结合二尖瓣频谱特点更为全面。     

血管回声跟踪技术评价冠心病颈总动脉弹性的应用

目的评价血管回声跟踪技术在冠心病患者颈总动脉弹性的应用价值。方法冠心病组56例,正常对照组38例。应用血管回声跟踪技术评估颈总动脉弹性参数,包括僵硬度(β)、弹性模量(EP)、顺应性(AC)、膨大指数(AI)及脉搏波传导速度(PWVβ)5项生理参数,并对上述参数进行统计学分析。结果冠心组颈总动脉β、EP、PWVβ较正常对照组增高(P0.01),AC较正常对照组降低(P0.01),AI较正常对照组增高(P0.05)。结论应用血管回声跟踪技术有助于评价冠心病患者颈总动脉弹性的功能改变。     

Coronary vasomotor response is related to the angiographic extent of coronary sclerosis in patients with stable angina pectoris

Disturbed vasomotor function in coronary arteries has clinical importance in early stages of coronary artery disease (CAD), as it may contribute to the potential risk for an ischaemic coronary event. In the present study, we have investigated the relationship between coronary vasomotor function and the extent of CAD. The response to acetylcholine and nitrate infusion was assessed by quantitative coronary angiography. The extent of CAD was categorized into two groups: minor CAD (normal coronary arteries and vessel wall irregularities) and significant CAD (one-, two- and three-vessel disease). A total of 277 patients with stable angina pectoris, referred for a first diagnostic coronary angiography, were eligible for analysis (mean age 57 years, 61% male). The response to nitrate was significantly impaired in patients with significant CAD ( P <0.001). On the other hand, the response to acetylcholine was not different between the two groups ( P =0.12); however, a trend between the response to acetylcholine and the extent of CAD was observed in patients without a previous infarction ( P =0.07), which was a significant interaction variable. Furthermore, a significant relationship between coronary vasomotor response and the number of cardiovascular risk factors was observed ( P <0.05). In conclusion, in a heterogeneous group of patients, coronary vasomotor function measured by nitrate infusion was more strongly associated with the extent of CAD and the number of risk factors than the response to acetylcholine. These data suggest that, in patients with advanced atherosclerosis or multiple risk factors, the vasomotor dysfunction is not solely restricted to the endothelium.     

间断血液透析滤过对尿毒症患者血管内皮细胞功能的影响

目的 探讨血液透析间断联合血液透析滤过对终末期肾病(end stage renal disease,ESRD)患者血管内皮功能及预后的影响.方法 ESRD患者按标准入选60例,随机分为血液透析组(HD组,n=30)和血液透析联合血液透析滤过组(HD/HDF组,n=30).选择10例健康人作为正常对照.彩色超声检测肱动脉血管舒张功能;并检测血清C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子(tumor necrosis factor α,TNFα)α、可溶性细胞间黏附分子-1(soluble intercellular adhesion molecule-1,sICAM)变化.同时观察2年内患者心脑血管疾病及病死率发生情况.结果 ①2组患者内皮依赖性舒张功能(endothelium dependent dilation,EDD)、非内皮依赖性舒张功能(endothelium independent dilation,EID)、反应性充血血流量及含服用硝酸甘油后血流量低于正常对照组者,血清CRP、TNFα、sICAM-l水平高于正常对照组,差异有统计学意义(均 P＜0.05);2组患者间治疗前上述各项指标差异均无统计学意义(均 P＞0.05).②2组患者随治疗时间的延长,EDD、EID、反应性充血血流量、含服硝酸甘油后血流量均逐渐降低,差异有统计学意义(均 P＜0.05),但HD/HDF组治疗后与HD组相同时间点比较,EDD、EID、反应性充血血流量、含服硝酸甘油血流量均高,sICAM-1 低,差异有统计学意义(均P＜0.05).③ HD组心脑血管疾病发生率高于HD/HDF组,差异有统计学意义(χ 2=6.239,P=0.012),HD与HD/HDF2组病死率分别为16.7%、3.3%,差异无统计学意义(χ 2= 3.208,P=0.073).结论 ESRD患者血管内皮功能紊乱;间断血液透析滤过能改善血管内皮功能,对减少ESRD患者心脑血管疾病的发生可能有一定的作用.     

冠心病患者肱动脉血管内皮依赖性舒张功能的超声检测

目的 利用高频超声评价冠心病（CAD）患者肱动脉内皮依赖性舒张功能（EDD）及其临床意义。方法 对113例连续冠脉造影（CAG）受检者术前行高频超声检查肱动脉EDD，并对两种检查结果进行相关性分析。结果 冠脉狭窄组、急性心肌梗死（AMI）组肱动脉EDD明显低于对照组（P〈0．01）；AMI组EDD显著低于心肌缺血组（P〈0．01）。结论CAD患者的EDD明显降低。     

全方向M型超声心动图评价冠状动脉疾病与扩张型心肌病心力衰竭患者左心室短轴的局部收缩功能

目的 应用全方向M型超声心动图(OME)评价冠心病(CAD)及扩张型心肌病(DCM)所致的心力衰竭患者左心室短轴的局部收缩功能.方法 以DCM组30例、CAD组30例患者及对照组30名健康志愿者作为研究对象.依据冠状动脉造影结果将CAD组分为CAD缺血节段亚组及CAD非缺血节段亚组,采集各组左心室短轴16个节段的全方向M型超声心动图曲线,分别测量收缩期内膜峰值运动速度(V)、加速度(A)、收缩期运动峰值相对力(F’)并进行对照分析.结果 与对照组16个节段相应室壁比较,DCM组的V、A、F’均明显减低(P均＜0.05);CAD缺血节段亚组分别与CAD非缺血节段亚组及对照组的16个节段相应室壁比较,V除在基底段的侧壁、下壁、后间隔,乳头肌段的下壁、后间隔,心尖段的后间隔比较差异无统计学意义(P均＞0.05)外,其他室壁节段均降低(P均＜0.05),A、F'■在16个节段室壁均减低(P均＜0.05).结论 A、F'对评价局部收缩功能异常较V更加敏感,OME可作为评价DCM和CAD所致心力衰竭患者的局部收缩功能的有效方法.     

Apolipoprotein E phenotypes in patients with coronary artery disease

The relationship between apolipoprotein E (Apo E) phenotypes and progression of coronary atherosclerosis was investigated in 125 patients with coronary artery disease (CAD) proven angiographically (101 males, 24 females). To elucidate the pure effect of Apo E phenotypes on lipoproteins and coronary atherosclerosis, patients with familial hypercholesterolemia were excluded from the subjects. As a control group, 129 normal healthy volunteers (84 males, 45 females) were studied. In the CAD group, VLDL and LDL levels increased and HDL level decreased regardless of Apo E phenotypes in both sexes. The incidence of E4 was higher and that of E2 was slightly lower in the CAD group than in the control group. Two patients with E5/3 who had high LDL-cholesterol levels were found in the male CAD group. LDL-cholesterol level in E3/2 was lower than in E4/3 and E3/3 in the male CAD group. VLDL-cholesterol/triglyceride and VLDL cholesterol/phospholipid ratios in E3/2 were significantly higher than in E4/3 and E3/3 in the male CAD group, but the difference was not so marked as found in typical type III hyperlipidemia. When the male patients with effort angina were examined, coronary score (index of the severity of CAD) was the lowest in E3/2. In addition, the mean age at the onset of CAD was significantly higher in E3/2 than in E4/3. In conclusion, E2 acts protectively against coronary atherosclerosis, while E4 promotes it through the modulation of LDL-cholesterol level.     

The importance of circulating levels of salusin-α, salusin-β, and heregulin-β1 in atherosclerotic coronary arterial disease

ObjectiveThe relationship between the severity of atherosclerotic coronary artery disease (CAD) and circulating levels of salusin-α, salusin-β and heregulin-β1 has been investigated. In addition, the relationship with these peptides and high sensitive C-reactive protein (hsCRP) has been investigated.MethodsThe study was conducted on 55 volunteers who had normal coronary angiography (CAG) as the control group, 35 volunteers with the degree of coronary artery stenosis below 50% in CA as the non-critical stenosis group, 37 volunteers with narrowing of one coronary artery above 50% as single vessel group and 41 volunteers with narrowing of more than one coronary artery above 50% as multi-vessel group. One hundred and thirteen volunteers have been included to CAD group.ResultsThere was no statistically significant difference in serum salusin-α levels between groups. Serum salusin-β ve hsCRP levels were significantly lower in control group compared to other groups and CAD group. There was no statistically significant difference in salusin-β and salusin-α levels in reciprocal comparison of other groups other than heregulin-β1 levels. Heregulin-β1 levels were significantly lower in 'non-critical occlusion' and 'multiple artery occlusion' groups compared to control group. Heregulin-β1 levels in 'single artery occlusion' group were significantly higher than control, 'non-critical occlusion' and 'multiple artery occlusion' groups.ConclusionSalusin-α levels does not indicate any significant differences between any groups in our study however the relationship of salusin-α with salusin- β and heregulin-β1 levels drives to cogitate that these peptides can be used as biomarkers and therapeutic approaches in CAD. We think that these peptides will be used in laboratories routinely in future in addition to hsCRP for CAD.     

Correlation of oxidative stress parameters and inflammatory markers in coronary artery disease patients

OBJECTIVES: In addition to many traditional risk factors for coronary artery disease (CAD) development, enhanced oxidative stress and inflammation are serious conditions that may also be classified as novel risk factors. In the present study, we assessed the relationship between several parameters of oxidative stress status [malonaldehyde (MDA), superoxide anion (O(2)(-)) and plasma and erythrocyte superoxide dismutase (SOD) activities] with high sensitivity C-reactive protein (hsCRP) and fibrinogen as inflammation markers. DESIGN AND METHODS: Oxidative stress status parameters, inflammation markers and lipid status parameters were measured in 385 subjects [188 coronary heart disease (CHD) patients with angiographically diagnosed coronary artery disease (CAD), 141 patients with occlusion >50% in at least one major coronary artery (CAD+) and 47 patients with occlusion less than 50% (CAD-), and 197 CHD-free middle-aged subjects (the control group)]. RESULTS: The plasma MDA concentration and the level of O(2)(-) in plasma were significantly higher in combination with significantly lower SOD activity in the CAD+ group vs. the control group. By using multiple stepwise regression analysis, fibrinogen and hsCRP showed independent correlation with MDA. Binary logistic regression analysis indicated that both MDA and O(2)(-) were significantly associated with CAD development and adjustment for inflammatory markers weakened this association in the case of MDA. CONCLUSIONS: The relationship between oxidative stress parameters and inflammatory species suggest their strong mutual involvement in atherosclerosis development that leads to CAD progression.